Provider Practice Essentials, LLC
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“Poison is in everything, and no thing is without poison. The dosage makes it either a poison or a remedy.” -Paracelsus, date unknown
For patients in septic shock or those that are dehydrated, administration of fluid is top priority to restore adequate intravascular volume, increasing cardiac output, augment oxygen delivery, and improving tissue oxygenation.
[Read more…] about Fluid Administration“This is it!”
This was my thought as I am aboard the plane from Phnom Penh, Cambodia on my way back home to Dallas, Texas. I had just spent 2 weeks in Cambodia – my first time after having been lucky to survive the Khmer Rouge. I was both exhausted and emotionally charged after a week of providing anesthesia on the medical mission trip and another travelling through Cambodia.
[Read more…] about What’s Your Mission: Part 2The purpose of this post is to explain the concept of sensitivity, specificity, predictive values, and likelihood ratios.
Screening tests (surveillance tests) are tools use to assess the likelihood that a patient may have a certain disease. They are not definitive, but if positive, will heighten suspicion that would warrant use of a gold standard diagnostic test to rule in or rule out a certain diagnosis. The goal of screening tests is to reduce the morbidity and mortality in a population group (Maxim, Niebo, & Utell, 2014). Examples of screening tests include routine EKGs, PSA, PAP smears, and mammograms. For example, a male with an elevated PSA may have prostate cancer, BPH, or prostatitis. Positive results of screening tests need to be compared to the established gold standard test that is regarded as definitive. In this case, a prostate biopsy is considered a definitive test, as it will reveal the etiology of the elevated PSA. Screening tests are less invasive and less costly, whereas the gold standard test may be more invasive, expensive, or too late (discovered during an autopsy). Ideally, gold standard tests, such as coronary angiography, breast biopsy, or colposcopy should have 100% sensitivity and specificity. However, in reality, this may not be the case, as it may be the best test given the clinical picture at the time (Maxim, Niebo, & Utell, 2014).
[Read more…] about Sensitivity, Specificity, Predictive Values, Pre/Post-test Probability, and Likelihood Ratios explainedPlease allow me to share my perspective on why I chose to travel across the world to provide medical care to people I do not know. But first, I am going to provide you with a little background on me.